Provider Demographics
NPI:1932637329
Name:THOMAS, SYLVIA LYNNE (MSW, LICSW)
Entity Type:Individual
Prefix:MISS
First Name:SYLVIA
Middle Name:LYNNE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355TH COMPONENT MAINTENANCE SQUADRON
Mailing Address - Street 2:3925 S. FLIGHTLINE ROAD BUILDING 5245, ROOM 120
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85707
Mailing Address - Country:US
Mailing Address - Phone:520-228-2287
Mailing Address - Fax:
Practice Address - Street 1:355TH COMPONENT MAINTENANCE SQUADRON
Practice Address - Street 2:3925 S. FLIGHTLINE ROAD BUILDING 5245, ROOM 120
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85707
Practice Address - Country:US
Practice Address - Phone:520-228-2287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.19018651041C0700X
WVDP009442511041C0700X
AZLCSW215281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical